<!DOCTYPE html>
<html>
<meta charset="utf-8">
<head th:include="include :: header"></head>
<link href="/js/css/layui.css" rel="stylesheet">
<body class="gray-bg">
	<div class="wrapper wrapper-content ">
		<div class="row">
			<div class="col-sm-12">
				<div class="ibox float-e-margins">
					<div class="ibox-content">
						<form class="form-horizontal m-t" id="signupForm">
							<input id="cid" name="cid" th:value="${carInfo.cid}"
								type="hidden">
							<div class="form-group">
								<label class="col-sm-3 control-label">用户手机号：</label>
								<div class="col-sm-8">
									<input id="mobile" name="mobile" th:value="${carInfo.mobile}"
										class="form-control" type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">车牌号/车架号：</label>
								<div class="col-sm-8">
									<input id="plateNumber" name="plateNumber"
										th:value="${carInfo.plateNumber}" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">车型：</label>
								<div class="col-sm-8">
									<input id="model" name="model" th:value="${carInfo.model}"
										class="form-control" type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">出发地：</label>
								<div class="col-sm-8">
									<input id="departure" name="departure"
										th:value="${carInfo.departure}" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">目的地：</label>
								<div class="col-sm-8">
									<input id="destination" name="destination"
										th:value="${carInfo.destination}" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">保险公司：</label>
								<div class="col-sm-8">
									<input id="insurer" name="insurer"
										th:value="${carInfo.insurer}" class="form-control" type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">保险公司电话：</label>
								<div class="col-sm-8">
									<input id="insurerMobile" name="insurerMobile"
										th:value="${carInfo.insurerMobile}" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">保险公司网站：</label>
								<div class="col-sm-8">
									<input id="insurerWebsite" name="insurerWebsite"
										th:value="${carInfo.insurerWebsite}" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">保单号：</label>
								<div class="col-sm-8">
									<input id="policyNumber" name="policyNumber"
										th:value="${carInfo.policyNumber}" class="form-control"
										type="text">
								</div>
							</div>
							<div class="form-group">
								<label class="col-sm-3 control-label">合同签约时间：</label>
								<div class="col-sm-8">
									<input id="contractTime" th:value="${contractTime}" name="contractTime" id="contractTime"
										class="form-control" type="text"
										placeholder="yyyy-MM-dd HH:mm:ss">
								</div>
							</div>
							<div class="form-group">
							<label class="col-sm-3 control-label">保单图片：</label>
								<div class="layui-upload">
									<button type="button" class="layui-btn" id="test1">上传图片</button>
									<button type="button" class="layui-btn layui-btn-primary" id="delImg">删除图片</button>
									<input id="policyImg" name="policyImg" th:value="${carInfo.policyImg}" class="form-control" type="hidden">
									<div class="layui-upload-list">
										<img class="layui-upload-img" style="width:200px;height:200px;" th:src="${carInfo.policyImg}" id="demo1">
										<p id="demoText"></p>
									</div>
								</div>
							</div>
							<div class="form-group">
								<div class="col-sm-8 col-sm-offset-3">
									<button type="submit" class="btn btn-primary">提交</button>
								</div>
							</div>
						</form>
					</div>
				</div>
			</div>
		</div>
	</div>
	<div th:include="include::footer"></div>
	<script src="/js/layui.js"></script>
	<script type="text/javascript" src="/js/appjs/car/carInfo/edit.js">
		
	</script>
</body>
</html>
